| NPI | 1891036372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELVIRA TOLENTINO Owner 862-377-4088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME113936) |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2013-03-08 |