| NPI | 1245671809 |
|---|---|
| Former Legal Business Name | NA |
| Entity Type | Organization |
| Authorized Contact | LIDIA WONG President 786-427-7442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL 9260896) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2013-07-11 |