| NPI | 1760625925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS CHEDIAK President 305-910-8071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL ME34153) |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2009-04-16 |