| NPI | 1730990169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YANNICK MCCOOK General Manager 954-336-9475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| Enumeration Date | 2025-01-15 |
| Last Update Date | 2025-01-15 |