| NPI | 1417017823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA BUSTAMANTE President 305-826-5655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: FL ME58534) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME58534) |
| 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: FL ME58534) | |
| 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: FL ME58534) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2010-07-19 |