| NPI | 1982004933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY MACKEY Ap 305-394-1792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS9185) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME 51339) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9168222) | |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-08-27 |