| NPI | 1821314956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN BLASDELL Administrator 954-946-4539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL ME89011) |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2010-04-14 |