| NPI | 1871015693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REMBERTO LOPEZ Owner/Physician 239-984-5610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME120649) |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2022-07-21 |