| NPI | 1144002080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAZARO ROBERTO DIAZ NUNEZ Managing Partner 239-428-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208D00000X General Practice | |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2025-02-07 |