| NPI | 1114116050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANNY J HERNANDEZ Physican/Owner 239-573-6111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME0041260) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2007-10-16 |