| NPI | 1659324184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALDO ALBERTO President 786-388-5887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2021-08-23 |