| NPI | 1891587986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SADITA BUSTAMANTE COO. 305-874-3909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2025-05-22 |
| Last Update Date | 2025-05-22 |