| NPI | 1578522967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIXTO MONTANO Credentialing Manager 305-403-6513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2024-03-26 |