| NPI | 1659571289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE RAFAEL PESQUERA-GARCIA Director 787-728-1193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: PR 7279) |
| Enumeration Date | 2007-07-22 |
| Last Update Date | 2007-07-22 |