| NPI | 1790292464 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | VIVIAN N/A ARIAS President 786-873-1426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2022-07-21 |