| NPI | 1750793295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YESENIA E. JUSTINIANO ROSARIO President 787-317-7792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: PR 17382) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2015-01-07 |