| NPI | 1891962205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD B MOORE Owner 772-299-0097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL mo-0048243) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL me-0048243) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2008-07-24 |