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