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 |