| NPI | 1700024015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX PONTIGO President 305-513-5752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2009-01-23 |
| Last Update Date | 2009-01-23 |