| NPI | 1801069224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA FUXA Adminstrator 954-392-7157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS7420) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME70790) |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2015-09-28 |