| NPI | 1578064077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRILL FILATOV CFO 305-901-5055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2025-09-24 |