| NPI | 1366839847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS E LANDESTOY Presidente 787-762-9424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: PR 278) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2015-04-22 |