| NPI | 1912956574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH MARIE JACOBUCCI R.N. 772-299-4623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL rn1861972) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2020-08-22 |