| NPI | 1306243381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH MINIET President 305-200-3871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: FL me52935) |
| Enumeration Date | 2014-11-19 |
| Last Update Date | 2014-11-19 |