| NPI | 1134460124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILLY PEREZ Physician 305-274-9890 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL ME75581) |
| Enumeration Date | 2013-03-15 |
| Last Update Date | 2013-05-09 |