| NPI | 1225356009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DULCE ZUNILDA TAVERAS UCETA Owner 239-919-4355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME98472) |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2010-05-04 |