| NPI | 1720381452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN R ISTAD Owner 772-398-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL CH6232) |
| Enumeration Date | 2010-12-20 |
| Last Update Date | 2011-03-11 |