| NPI | 1861780694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YANITZA RODRIGUEZ Director 770-380-3498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: FL ME 107763) |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2011-10-26 |