| NPI | 1912192642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILMER HARRY VALENTIN President 787-884-0505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: PR 6911) |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2009-09-15 |