| NPI | 1356919971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRNA GRANDADOS President 305-588-7577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2021-06-11 |
| Last Update Date | 2022-01-28 |