| NPI | 1811446933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | XIN TONG Owner 561-609-9555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: FL Ap3262) |
| Additional Taxonomies | 305S00000X Point of Service (Licence: FL Ap3566) |
| 305S00000X Point of Service (Licence: FL Ap3743) | |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2017-04-10 |