| NPI | 1255612867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNER GUTIERREZ President Owner 786-423-2690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL HCC9345) |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2011-09-09 |