| NPI | 1750742904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MARQUIS Owner 561-430-3492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL OS7851) |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2016-03-16 |