| NPI | 1679121149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA C PADRON VP 786-390-5671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2022-04-14 |