| NPI | 1619401338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLADYS FERNANDEZ-CORTES Managing Director 305-498-4034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2017-04-19 |