| NPI | 1831187798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA R. FAGAN Owner 305-246-8224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 647292) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2020-08-22 |