| NPI | 1528756830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA MONTES Provider Enrollment Specialist 786-406-0925 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy |
| Enumeration Date | 2023-04-25 |
| Last Update Date | 2023-04-25 |