| NPI | 1922448497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS LEE GOTLIN President 786-320-5870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL 1300011234) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2022-02-17 |