NPI | 1730646787 |
---|---|
Entity Type | Organization |
Authorized Contact | LARRY DE JESUS President 786-518-1911 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207R00000X Internal Medicine |
Enumeration Date | 2019-02-26 |
Last Update Date | 2020-07-14 |