| NPI | 1689977951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE GILBERTO CRUZ Manager 863-324-7121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2022-09-30 |