| NPI | 1376797027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUSTAVO DE LA PORTILLA President 305-255-1966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME83614) |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2016-04-28 |