| NPI | 1659702199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GIL NIEVES LATIMER President 787-753-8514 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: PR 599143713) |
| 302R00000X Health Maintenance Organization | |
| 305R00000X Preferred Provider Organization | |
| 305R00000X Preferred Provider Organization | |
| 305S00000X Point of Service | |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2022-07-21 |