| NPI | 1124369111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDINO GONZALEZ Physician 305-274-9890 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL ME75564) |
| Enumeration Date | 2013-03-15 |
| Last Update Date | 2013-05-09 |