| NPI | 1548958796 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | PATRICIA MONTES Provider Enrollment Specialist 305-595-0109  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy | 
| Enumeration Date | 2023-04-26 | 
| Last Update Date | 2023-04-26 |