| NPI | 1952759425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MARQUIS Medical Director 954-457-4201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL OS7851) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2016-05-25 |