| NPI | 1548806334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BELITA WYATT Chief Executive Officer 786-318-2337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-11-27 |
| Last Update Date | 2024-02-04 |