| NPI | 1528318771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYLAINE RIOBE Director 772-266-4258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ME82630) |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2012-09-14 |