| NPI | 1831665694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER REYES Administrator 786-253-7699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2019-06-11 |