| NPI | 1194598623 |
|---|---|
| Former Legal Business Name | P.R. MED VITALITY LLC |
| Entity Type | Organization |
| Authorized Contact | JENNIFER SURIS CANCEL Sole Mbr 939-299-0113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2023-11-06 |