| NPI | 1104217645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROLANDO VERGEL CESPEDES President 786-366-0531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL ME93644) |
| Enumeration Date | 2015-02-05 |
| Last Update Date | 2015-02-05 |