| NPI | 1609199017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVELICE A VILLAMAN-BENCOSME Owner 954-392-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL ME64482) |
| Enumeration Date | 2010-03-12 |
| Last Update Date | 2010-03-12 |