| NPI | 1104369719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN MALDONADO Owner 561-578-4582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: FL ME92323) |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2020-12-02 |