| NPI | 1861766941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA VALLADARES WALLACE Owner 954-721-8202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: FL os 10688) |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2012-03-07 |