| NPI | 1790212942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESUS YSIDRO HERNANDEZ President 786-476-7314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME27608) |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2017-07-14 |