| NPI | 1780126672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLANCA NELIDA GONZALEZ Owner 786-801-1693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME106369) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2016-11-09 |