| NPI | 1912115965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERTO ALVAREZ GINZO President 305-255-1127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL ME86012) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |