| NPI | 1548090855 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MARLIES T GONZALEZ LLANTAD President 786-803-8827  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | 
| Additional Taxonomies | 207Q00000X Family Medicine | 
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2024-08-02 | 
| Last Update Date | 2025-01-09 |