| NPI | 1447796339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUILLERMO ANTONIO FONSECA President 305-223-3989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME0064061) |
| Enumeration Date | 2017-01-16 |
| Last Update Date | 2017-01-16 |