| NPI | 1689901688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN LINES Clo 954-408-8672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2026-05-20 |