| NPI | 1144815473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDIDO O BETANCOURT Owner 786-282-6372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2021-10-22 |