| NPI | 1760724355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GIANNYS MATO Owner 305-848-6376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME91436) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME28850) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2015-09-25 |