| NPI | 1083663850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GISELLE IBANEZ President/Owner 786-365-7837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: FL HCC7552) |
| Additional Taxonomies | 261Q00000X (Licence: FL 517104-6) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2013-05-22 |