| NPI | 1578151197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA MANCEBO Ambr 786-239-4273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2021-08-06 |