| NPI | 1700387644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLOW BLAS HERNANDEZ CEO 954-514-9360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2020-04-21 |