| NPI | 1760098099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OCTAVIO RODRIGUEZ Adm 786-641-1312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2020-12-27 |