| NPI | 1790392892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS RODRIGUEZ Owner 786-452-6858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2020-09-23 |
| Last Update Date | 2024-04-22 |