| NPI | 1760679088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIEGO T TORRES Managing Member 386-676-2367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME79483) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2007-10-01 |