| NPI | 1750430864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD QUINTANA Health Services Technician 305-535-4350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider (Licence: FL Q535-740-86-208-0) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-08-22 |