| NPI | 1962540591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM EDWARD PORTER Owner 561-714-4527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL ME87260) |
| Enumeration Date | 2007-02-03 |
| Last Update Date | 2020-08-22 |