| NPI | 1205452067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS PROENZA Owner 954-669-1125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 111N00000X Chiropractor |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2020-06-17 |