| NPI | 1609536853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEANET CABRERA Administrator 786-360-5558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2021-12-28 |
| Last Update Date | 2023-10-17 |