| NPI | 1780236299 |
|---|---|
| Doing Business As | N/A |
| Entity Type | Organization |
| Authorized Contact | MELITO REATEGUI MONTOYA President 787-869-6086 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2019-07-15 |