| NPI | 1407973217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENRIQUE J RUEDA Pa 305-554-1491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9101498) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9101498) |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9101498) | |
| Enumeration Date | 2007-03-25 |
| Last Update Date | 2020-08-22 |