| NPI | 1851861934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RIGOBERTO CORDERO Owner 786-970-9843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 251S00000X Community/Behavioral Health | |
| 261Q00000X | |
| Enumeration Date | 2018-11-30 |
| Last Update Date | 2021-06-08 |