| NPI | 1124440227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRIAM MERCEDES LARA M.D. 305-362-3969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL ME0047182) |
| Enumeration Date | 2014-01-09 |
| Last Update Date | 2014-01-09 |