NPI | 1912579673 |
---|---|
Entity Type | Organization |
Authorized Contact | PENELOPE KOKKINIDES Chief Administrative Officer 321-332-6947 |
Organization Subpart ? | Yes |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
207RN0300X Internal Medicine, Nephrology | |
207VG0400X Obstetrics & Gynecology, Gynecology | |
Enumeration Date | 2021-07-13 |
Last Update Date | 2024-10-18 |