| NPI | 1104895424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANUELLA JANVIER-ANGLADE Program Administrator 786-624-2490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2008-06-13 |