| NPI | 1679891063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA CRUZ Practice Administrator 561-637-1453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME67047) |
| Enumeration Date | 2010-05-10 |
| Last Update Date | 2010-05-10 |