| NPI | 1780866848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN E SELUB Owner 954-217-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL ME60149) |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2019-07-15 |