| NPI | 1720063092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE AMY GRUNDSTEIN Medical Director 305-477-2329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL me74252) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2020-08-22 |