| NPI | 1134717036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUIDO LOPEZ Administrator 786-353-2573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-01-06 |
| Last Update Date | 2021-09-22 |