| NPI | 1053764001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HECTOR RAMOS MENDEZ Doctor 386-898-6783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL ch10745) |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation (Licence: FL CH10745) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |