| NPI | 1841038544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN MADRUGA Owner 786-309-0168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| 208D00000X General Practice | |
| 251S00000X | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2024-07-17 |
| Last Update Date | 2024-12-04 |