| NPI | 1740730688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD POLAKOFF Medical Doctor 954-676-5183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: FL me0046546) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2016-10-24 |