| NPI | 1255052544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS E MENDEZ LUACES Clinical Director 305-363-1880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2024-01-29 |