| NPI | 1881868024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STUART BERK Owner 321-799-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL os9767) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2008-12-31 |