| NPI | 1902214091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS A MACHADO President 305-915-4134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: FL MA69369) |
| Enumeration Date | 2014-08-01 |
| Last Update Date | 2014-08-01 |