| NPI | 1255339750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIO FLORES CEO 319-768-5858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 000671) |
| 363L00000X Nurse Practitioner (Licence: IA A045847) | |
| 208000000X Pediatrics (Licence: IA 17758) | |
| 207R00000X Internal Medicine (Licence: IA 35097) | |
| 207R00000X Internal Medicine (Licence: IA 37355) | |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2023-01-25 |