| NPI | 1609135128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNANDO V MATA President 954-938-7011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME0047345) |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2012-05-04 |