| NPI | 1811288012 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ROSEMERY ESTEVEZ Dir Contracting And Credentialing 954-262-4343 | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 106H00000X Marriage & Family Therapist | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| 133N00000X Nutritionist | |
| 133VN1004X Dietitian, Registered, Nutrition, Pediatric | |
| 208000000X Pediatrics | |
| 225100000X Physical Therapist | |
| 2251P0200X Physical Therapist, Pediatrics | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2011-04-22 | 
| Last Update Date | 2025-06-11 |