| NPI | 1851771000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA ESTHER SOTO CEO/Medical Billing Director 386-410-3742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL L15000089664) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2015-06-03 |