| NPI | 1174748164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERBERT VALENCIA Surgical Assistant 305-324-7444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171W00000X Contractor (Licence: FL RN9205521) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |