NPI | 1417108879 |
---|---|
Entity Type | Organization |
Authorized Contact | ELIZABETH FUENTES Billing/ Credentialing Clerk 305-412-2800 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: FL ME 0064553) |
Enumeration Date | 2008-10-03 |
Last Update Date | 2008-10-03 |