| NPI | 1912735572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNESTO LEONEL DIAZ Owner 786-351-9892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-07-24 |
| Last Update Date | 2024-08-07 |