| NPI | 1568974368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGLEY MOREJON Owner 786-631-5116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 251S00000X | |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2022-05-13 |