| NPI | 1992304216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE RACHEL PREVILUS Administrator 561-301-8675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2025-07-15 |