| NPI | 1770380792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADELEYNE BOFILL Owner 786-357-7968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 163W00000X Registered Nurse |
| Enumeration Date | 2025-02-26 |
| Last Update Date | 2026-06-15 |