| NPI | 1417316027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THELMA RIVERA Administrator 561-434-7577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL 0076064) |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2022-07-21 |