| NPI | 1710271333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY JACOBSON Physician 954-661-8151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME0059609) |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2011-05-31 |