| NPI | 1528062049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN ROSADO Owner 787-868-8769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: PR 5067500001) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2020-08-22 |