| NPI | 1063341592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CELIO HERNANDEZ Manager 786-757-1941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2026-05-19 |
| Last Update Date | 2026-06-18 |