NPI | 1003467960 |
---|---|
Entity Type | Organization |
Authorized Contact | EDGARDO CASTILLO Chief Medical Officer 239-368-7310 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Enumeration Date | 2019-09-23 |
Last Update Date | 2019-09-23 |