| NPI | 1154609642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORGE BETANCOURT Owner/President 305-649-1395 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME0041415) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME0041415) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2011-08-01 |