| NPI | 1255955761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGRID BADILLO GONZALEZ Owner 346-546-9653 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care |
| 133NN1002X Nutritionist Nutrition, Education | |
| 207Q00000X Family Medicine | |
| 225700000X Massage Therapist | |
| 363LF0000X Nurse Practitioner Family | |
| 103T00000X Psychologist | |
| 2085B0100X Radiology Body Imaging | |
| 171100000X Acupuncturist | |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2025-10-27 |