NPI | 1417288200 |
---|---|
Entity Type | Organization |
Authorized Contact | VILMA BARRAMEDA Owner/Operator 786-290-3012 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: FL MA 41724) |
Enumeration Date | 2010-01-19 |
Last Update Date | 2010-02-03 |