| NPI | 1740553569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETHA HAYNES Owner 954-492-7150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: LA 27302) |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2023-04-21 |