| NPI | 1528610136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORGE L MANSO President 786-266-0956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2019-07-13 |
| Last Update Date | 2023-03-16 |