| NPI | 1912510751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREETTEL O PORTAL Mbr 305-748-3462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2020-08-30 |
| Last Update Date | 2021-08-12 |