| NPI | 1750899837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS K VELLEFF Medical Director 321-241-6441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X (Licence: FL ME42998) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME42998) |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2018-01-11 |