| NPI | 1699863936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCELLA GRAVALESE Authorized Official 561-955-5155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2025-04-18 |