| NPI | 1457760712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULINA T DORVAL Managing Member 786-546-5129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 3078052) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME94972) |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2014-08-11 |