| NPI | 1902992431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLENA M BANAS Clinical Manager 305-252-7575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: FL 389855-9) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |