| NPI | 1285935825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA MEDINA President 786-662-9188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: FL 13096) |
| Enumeration Date | 2010-11-13 |
| Last Update Date | 2010-11-13 |