| NPI | 1386243822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENIA LAZO SANTALLA President 954-280-2056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2020-10-24 |
| Last Update Date | 2024-11-07 |