| NPI | 1740737709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CHEN Chief Operating Officer 305-831-4760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2023-03-07 |