| NPI | 1891063285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE MILBURN Owner 321-453-8770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL 0046644) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |