| NPI | 1689931834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIVAN RODRIGUEZ President/ Owner 239-288-7457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL MM28888) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2012-04-12 |