| NPI | 1053340265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZBET GOMEZ President 305-644-5990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: FL 176840-0003) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2020-08-22 |