| NPI | 1205301942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIEL LOZADA Owner/President 239-841-6797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health |
| 225100000X Physical Therapist | |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2020-01-24 |