| NPI | 1669636791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA SIMONE CARROLL SCOTT Medical Director 305-662-5988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL ME67630) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2008-07-17 |