| NPI | 1366752479 |
|---|---|
| Former Legal Business Name | MIRACLE WELLNESS CENTER, INC. |
| Entity Type | Organization |
| Authorized Contact | ZALMA M MARINO President 305-456-0798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Enumeration Date | 2010-10-08 |
| Last Update Date | 2010-10-08 |