| NPI | 1063839355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADELAINE SOLER Owner 786-419-0642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL L14000034750) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2014-03-25 |