| NPI | 1073069456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIOVES PORTILLO Manager 305-854-8446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2016-08-26 |