| NPI | 1235453168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANUEL DE JESUS GAINZA Medical Director 772-224-2467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME86679) |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2010-03-22 |