| NPI | 1730374752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA B. BRADLEY President 561-676-2989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: DC PRC13943) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2007-09-12 |