| NPI | 1497060529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELSY M CORONADO Owner 305-710-9937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL ME91527) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2011-02-10 |