| NPI | 1174390454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS ALBERTO DIAZ VALLADARES Owner 786-488-4301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-12-07 |
| Last Update Date | 2024-03-12 |