| NPI | 1770827917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTO A NICODEMO Director 305-264-0124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9101023) |
| Enumeration Date | 2012-11-11 |
| Last Update Date | 2012-11-11 |