| NPI | 1336656495 |
|---|---|
| Former Legal Business Name | PROLIVE MEDICAL RESEARCH CORP |
| Entity Type | Organization |
| Authorized Contact | LAURA DIAZ Site Director 305-221-8001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2018-01-10 |