| NPI | 1679872600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN J JANKOWSKI Assistant Chief 305-575-3219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: FL SW7498) |
| Enumeration Date | 2011-03-16 |
| Last Update Date | 2011-03-16 |