| NPI | 1962487546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODOR MAJOR RUDOLPH Medical Director/Medical Doctor 772-299-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME79805) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2020-08-22 |