| NPI | 1649727074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE GUSTAVO CEVALLOS President 305-790-6544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: FL ME114288) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2023-12-08 |