| NPI | 1790884419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAIN MORALES Owner 786-525-6691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: FL HCC7191) |
| Additional Taxonomies | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: FL 683231) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |