| NPI | 1083995872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAFAEL ENRIQUE URENA Owner 754-223-5335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: FL CH7802) |
| Enumeration Date | 2011-09-07 |
| Last Update Date | 2011-09-07 |