| NPI | 1578623591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE AGUSTIN LUIS Owner 305-279-4446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: FL 34113) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-08-22 |