NPI | 1134642465 |
---|---|
Former Legal Business Name | EBENEZERMED |
Entity Type | Organization |
Authorized Contact | RENE ELADIO DISOTUAR ABAD President 305-330-5393 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2017-07-18 |
Last Update Date | 2022-07-21 |