| NPI | 1053172007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAIDEL RODRIGUEZ FAJARDO Owner 786-416-4867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2024-01-17 |
| Last Update Date | 2024-01-17 |