| NPI | 1952572430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH J PALESTRANT Physician 772-343-1774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL FP0126222) |
| Enumeration Date | 2008-03-12 |
| Last Update Date | 2008-03-12 |