| NPI | 1912223751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH F. GUERRIER Director 305-758-3348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL ME42139) |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2013-03-06 |