| NPI | 1740978741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS A MARIN Director 786-308-1695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-04-27 |
| Last Update Date | 2023-04-27 |