NPI | 1043480502 |
---|---|
Entity Type | Organization |
Authorized Contact | AGUEDA BOUZA Provider Service Manager 305-278-0200 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: FL 5943) |
Enumeration Date | 2008-03-11 |
Last Update Date | 2025-10-07 |