| NPI | 1407641582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NESTOR FONSECA Administrator 305-298-2123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2025-04-10 |
| Last Update Date | 2025-09-08 |