| NPI | 1972905099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMAR FADHLI Owner 407-343-9006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PAT 9108176) |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2014-09-19 |