NPI | 1821679911 |
---|---|
Entity Type | Organization |
Authorized Contact | TAMARA LYNETTE SUKIE Owner 561-562-1816 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 363L00000X Nurse Practitioner |
Enumeration Date | 2021-04-20 |
Last Update Date | 2023-09-13 |