| NPI | 1093138067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS ROBERTO SOTO Administrator 787-431-9470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: PR 16689) |
| Enumeration Date | 2014-01-28 |
| Last Update Date | 2014-10-27 |