NPI | 1699220749 |
---|---|
Entity Type | Organization |
Authorized Contact | LEANNE MASCARO Director Of Mso 786-210-1896 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 171W00000X Contractor |
Enumeration Date | 2016-08-18 |
Last Update Date | 2023-11-08 |