| NPI | 1811495583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE LEE TAYLOR Owner / Registered Agent 561-202-4861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME125557) |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2018-01-29 |