| NPI | 1912242751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANUEL VIZCARRONDO Director 787-824-6392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: PR 8733) |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2012-12-05 |
| Last Update Date | 2012-12-06 |