| NPI | 1750396339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAREL DEAN PRUETT Owner 305-664-8828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL 4528) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2008-10-09 |