| NPI | 1265854483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRISEL VALDES Owner 786-348-1166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 111NR0400X |
| Enumeration Date | 2014-01-07 |
| Last Update Date | 2014-01-07 |