| NPI | 1902653512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORGAN T MAYFAIRE Executive Director 954-667-2916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2024-05-01 |
| Last Update Date | 2024-05-01 |