| NPI | 1104247188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT CARRODEGUAS CEO 305-398-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2022-04-18 |