| NPI | 1922268531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM COFFMAN Owner 561-964-0707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 983) |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2021-05-24 |