| NPI | 1780450288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENESSIA NORVIL Provider 786-870-9293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2025-05-08 |