| NPI | 1649600883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY LOPEZ President 786-499-3499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2022-01-25 |