| NPI | 1255933115 |
|---|---|
| Doing Business As | CENTRO MEDICO SAN LUCAS |
| Entity Type | Organization |
| Authorized Contact | BYRON OSWALDO MATA Owner 786-427-4450 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| Enumeration Date | 2020-11-14 |
| Last Update Date | 2020-11-14 |