| NPI | 1225131477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENATO ASCENSIO ALFONSO President 386-439-9777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL D049) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2009-07-15 |