| NPI | 1003314568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAGOBERTO DE LA VEGA President 305-400-8774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2018-01-30 |
| Last Update Date | 2018-01-30 |