| NPI | 1508295916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORLY GUERON Director 305-924-6555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: FL MT 2306) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2013-11-06 |