| NPI | 1760627517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OCTAVIO ALEXIS BRAVO Managing Member 786-422-6525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL HCC8316) |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2008-12-09 |