| NPI | 1710831060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE GONZALEZ Credentialing Manager 954-696-3363 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2026-02-24 |
| Last Update Date | 2026-02-24 |