| NPI | 1437404381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS DOMINGUEZ Owner 305-860-5407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME 113513) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-12-04 |