| NPI | 1679072375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY LUBY Billing Manager 321-259-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME53320) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL ME81283) |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2018-02-08 |