| NPI | 1245414911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNANDO MELOCOTON ABANILLA Owner 863-314-0555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL ME0066898) |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2008-04-15 |