| NPI | 1487779153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR ANGEL COVARRUBIAS Physician 561-622-3875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME 36593) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2010-07-28 |