| NPI | 1790824522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEMMA I MENDOZA Vice President Secretary 772-562-5232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL 0025811) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-08-22 |