| NPI | 1407946585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNANDO ENRIQUE VISBAL Administrator 787-603-6868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 164164) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-08-22 |