| NPI | 1861413957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISIDRO GUILLERMO PENTZKE Owner 561-585-0640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME67383) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2008-02-07 |