| NPI | 1679919831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY B LICATA President 954-336-0409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2013-05-15 |