| NPI | 1104408624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZET LOPEZ President 305-219-8606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2021-04-23 |
| Last Update Date | 2021-10-11 |