| NPI | 1932415635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD DURNAN Managing Member 561-433-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL 8817) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2012-03-15 |