| NPI | 1730424763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CERECEDA Mbr 954-963-1899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2012-12-03 |