| 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 |