| NPI | 1639360852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NARCISO REYES CARRILLO Owner 787-889-3453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: PR 10968) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2007-08-05 |