| NPI | 1619549755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS LEDESMA Owner/Administrator 305-335-9627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2024-09-19 |