| NPI | 1811398811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS VISSEPO Attorney 954-399-4618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2021-10-12 |