| NPI | 1861487787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY TESIC CEO 561-338-6897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: FL OS6072) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH0006645) |
| 174400000X Specialist (Licence: FL PT12916) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2014-05-22 |