NPI | 1619521010 |
---|---|
Entity Type | Organization |
Authorized Contact | RUBER LABORDE Owner 786-290-6828 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207R00000X Internal Medicine |
261QM1300X Clinic/Center, Multi-Specialty | |
363L00000X Nurse Practitioner | |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2019-07-24 |
Last Update Date | 2022-06-13 |