| NPI | 1174615512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEDRO RAFAEL BADILLO President 787-638-7648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: PR 4122) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-08-22 |