| NPI | 1851924476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE POWELL-GILLIS Owner Of Entity 954-366-5182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261Q00000X |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2021-09-13 |