| 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 |