| NPI | 1205549300 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ARACHRISTIE OTERO DIAZ Owner 939-332-4787  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services | 
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care | 
| 261QM2500X Clinic/Center, Medical Specialty | |
| Enumeration Date | 2023-01-04 | 
| Last Update Date | 2023-01-09 |