| NPI | 1336433648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOURDES NIEVES Owner 305-491-3203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL 232190) |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2011-06-03 |