| NPI | 1174990915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARICELA DIANEXI FARDALES Owner 305-400-9702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL PA9103093) |
| Enumeration Date | 2015-08-27 |
| Last Update Date | 2021-05-14 |