| NPI | 1861880353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE CARRILLO-MASSA Owner 561-385-7591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME115891) |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2015-01-06 |