| NPI | 1932567088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL SUDACK Owner 305-887-4494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL 41103) |
| Enumeration Date | 2016-02-04 |
| Last Update Date | 2016-02-04 |