| NPI | 1871935452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN BALKARAN Assistant Administrator 321-251-1837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2013-07-24 |