| NPI | 1083346092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE M CAMACHO CRUZ CEO 321-314-3620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| 261QM0801X | |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2023-09-20 |