| NPI | 1700713112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN ALBERTO SANTIAGO RODRIGUEZ CEO 939-202-3265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2026-05-07 |
| Last Update Date | 2026-05-07 |