| NPI | 1245373232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK JOSE BALLESTEROS Doctor 305-892-4753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL ME55074) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2020-08-22 |