| NPI | 1528557394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA MARTINEZ Owner / Provider 305-989-7291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105777) |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2018-05-07 |