| NPI | 1871698027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENE CASANOVA Medical Director 954-816-7795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ACN961) |
| 2080A0000X Pediatrics, Adolescent Medicine | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2018-03-17 |