| NPI | 1760361414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIDIA IRENE PEREZ PEREDA Authorized Official 305-440-9010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2025-08-28 |
| Last Update Date | 2025-09-01 |