| NPI | 1912151481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOUHANNAD DALAO Owner 239-438-1067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2024-04-29 |