| NPI | 1366060766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD COLLAZO PAGAN Director 787-918-8618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-07-12 |
| Last Update Date | 2022-01-10 |