| NPI | 1750817052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULETTE RENE GIBBONS Therapist 786-374-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: FL MH14006) |
| Additional Taxonomies | 251S00000X (Licence: FL MCAP100270) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2017-05-04 |