| NPI | 1205588423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHRISTOPHER LUCIN-CACERES Program Director 786-830-8171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-01-19 |
| Last Update Date | 2024-06-14 |