NPI | 1720615693 |
---|---|
Entity Type | Organization |
Authorized Contact | AMANDA LYNN ESPINAL COO 772-307-9840 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2020-03-23 |
Last Update Date | 2024-03-25 |