| NPI | 1952777229 |
|---|---|
| Other Name | FLORIDA |
| Entity Type | Organization |
| Authorized Contact | MAYANK SHAH Medical Senior Director 312-262-2739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208D00000X General Practice | |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2022-02-02 |