| NPI | 1689294928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE WAUGH Nurse Practitioner 954-399-8793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2022-08-17 |