| NPI | 1447768452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMAR MONTESINO Chief Executive Officer 786-615-2572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2023-11-14 |