| NPI | 1861376352 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | GIONIS N/A THOMAS President 786-849-2569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2025-08-05 |
| Last Update Date | 2025-08-07 |