| NPI | 1326253618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIBRADO FUENTES President 786-267-1629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL HCC7623) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |