| NPI | 1023335767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERNAN DIAZ BOLANO Owner/Physician 786-394-3429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 44883) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2010-04-20 |