| NPI | 1013379957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BELMAR IRIZARRY GARCES Owner 787-242-2279 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: FL ME120944) |
| Enumeration Date | 2016-03-21 |
| Last Update Date | 2017-04-20 |