| NPI | 1114316015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HILDA DE LA PEDRAJA Owner 786-707-0365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: FL PA9100780) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2015-01-15 |