| NPI | 1205185469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARIEL MEDINA President 305-233-1330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL OPC 4155) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: FL OPC 4155) |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2013-04-12 |