| NPI | 1093241465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIAN DOMINGUEZ President 305-392-0765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261Q00000X (Licence: FL hcc11007) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2023-09-11 |