| NPI | 1538403860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YAZMIN V MALDONADO Owner 786-360-3928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation (Licence: FL MM29988) |
| Additional Taxonomies | 261QR0400X Clinic/Center Rehabilitation |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2012-11-27 |