NPI | 1548706104 |
---|---|
Entity Type | Organization |
Authorized Contact | AGUEDA BOUZA Provider Service Manager 305-278-0200 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: FL ME-53888) |
Enumeration Date | 2017-01-06 |
Last Update Date | 2024-04-26 |