| NPI | 1619574092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIRAMAD SAINZ Manager 305-982-8771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2021-10-22 |