| NPI | 1598375040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUAIT VEGA MALAGON Mgr 786-412-2834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 251S00000X | |
| Enumeration Date | 2020-08-08 |
| Last Update Date | 2022-03-31 |