| NPI | 1790112688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN KONDAS Officer 954-838-2371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2013-10-09 |
| Last Update Date | 2019-08-25 |