| NPI | 1851790554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME JOSE PEREZ President 386-215-5241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: FL CH11036) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2014-08-19 |