| NPI | 1730697327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETELL KAMANEL President 786-801-0218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL HCC10414) | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2020-07-07 |