| NPI | 1538624044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA RIVERO Owner 786-540-2363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2019-02-08 |