| NPI | 1275298481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHEL CASTILLO MADRIGAL Manager 786-394-0632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine | |
| 2084S0010X Psychiatry & Neurology, Sports Medicine | |
| 213E00000X Podiatrist | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| 332900000X Non-Pharmacy Dispensing Site | |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2024-08-14 |