| NPI | 1740408103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVIS FONSECA Billing Manager 305-292-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: FL ME61307) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |