| NPI | 1780739946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAZARO LUIS CASTILLO President Owner 239-549-1398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KI0005X Allergy & Immunology Clinical & Laboratory Immunology (Licence: FL ME74018) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2008-01-03 |