| NPI | 1417233222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY LOPEZ President/ CEO 786-360-4528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 208D00000X General Practice |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2022-01-25 |