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 |