| NPI | 1518623164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENE DAVID SIFONTES MEJIAS Owner 786-317-7495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2021-11-09 |