| NPI | 1396235347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFONSO ALFONSO President 786-205-8684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: FL P236200827620) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2023-12-19 |