| NPI | 1326464199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERMAN LESTER CARRERO Owner/Doctor 386-299-3144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL CH10337) |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2014-03-17 |