| NPI | 1972021400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLENE CORDOVA President 954-392-7157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2019-07-08 |