| NPI | 1902175292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YIRA L DE LA PAZ President 888-920-5599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME89466) |
| Enumeration Date | 2011-12-15 |
| Last Update Date | 2014-02-14 |