| NPI | 1881125128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA IACULLO Director Of Billing 954-461-7435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2017-03-27 |