| NPI | 1467753863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIDICE B LOPEZ President 305-528-0447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA 9104530) |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2010-11-16 |