| NPI | 1629419197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS J HERNANDEZ Vicepresident 787-674-0745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: PR 4191873) |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2013-07-12 |