| NPI | 1457762882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIMI MARQUEZ Office Manager 305-476-0244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL ME48235) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2014-05-20 |