| NPI | 1801604707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASANDRA LEE Owner 561-598-9609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2024-12-23 |
| Last Update Date | 2024-12-23 |