| NPI | 1417251448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSQUIN DUANY-GONZALEZ Owner 786-468-3034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: FL ME25040) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: FL ME 25040) |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2013-05-28 |