| NPI | 1659775393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN GRAY CEO 954-292-8657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA3649) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA3649) |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2014-10-09 |