| NPI | 1700323458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | XAVIER MARTINEZ Billing Officer 305-269-6783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN613) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME15332) |
| 208D00000X General Practice (Licence: FL ME90682) | |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2017-01-19 |