| NPI | 1750656781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOSO E HERNANDEZ President 239-288-5413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL AHCA HCC9389) |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2012-06-27 |