| NPI | 1811202328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE JOSEPH FORTUNA Director 954-876-0945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: FL ME46908) |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2010-08-10 |