| NPI | 1821425802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTTO BALBINO ELCORO President Owner 305-642-8718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL HCC7167) |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2013-10-04 |