| NPI | 1639421928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLANCA N GONZALEZ CEO 305-484-8969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: FL ME106369) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2012-10-10 |