| NPI | 1861002362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNESTO RODRIGUEZ TANQUERO President 786-227-2966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-08-09 |
| Last Update Date | 2021-10-14 |