| NPI | 1194312611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAUDEL ALFONSO Owner 305-916-6231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| 103K00000X Behavior Analyst | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2020-12-30 |
| Last Update Date | 2023-01-26 |