| NPI | 1770624066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUILLERMO HORACIO FERNANDEZ Administrator 954-362-0104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: FL 5173) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2020-08-22 |