| NPI | 1174587778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIEGO J GANUZA Assistant To The Administrator 305-962-0355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2020-08-22 |