| NPI | 1063849099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEDRO ENRIQUE DIAZ President/Owner 786-419-3480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME 64482) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME 64482) |
| 225700000X Massage Therapist (Licence: FL MA 46170) | |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2013-10-07 |