| NPI | 1770501264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIEL F GRULLON Administrator 954-577-3003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL HCC3962) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-08-22 |