| NPI | 1851625248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM JULIO DE JESUS Medical Director 787-798-4592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0805X (Licence: PR 14745) |
| Additional Taxonomies | 2084P0805X (Licence: PR 3032) |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2013-10-17 |