| NPI | 1972764223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJENDRA K. BANSAL Medical Director 772-283-4093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207RR0500X Internal Medicine, Rheumatology | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2008-06-19 |