| NPI | 1124016308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN DE LA CRUZ GONZALEZ Owner/President 305-223-7913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL HCC4904) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2008-09-10 |