| NPI | 1548090855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLIES T GONZALEZ LLANTAD President 786-803-8827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2024-08-02 |
| Last Update Date | 2024-09-04 |