| NPI | 1023083102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCAS PORRELLO President 305-270-7771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ME63386) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2010-01-06 |