| NPI | 1851955793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE DE TERREFORTE-DIAZ Chief Executive Officer 939-545-0522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2020-02-28 |