| NPI | 1700242617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS MEDINA Owner 786-817-7808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME106831) |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2020-08-13 |