| NPI | 1912779984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OCTAVIO DE JESUS CARRENO Manager 305-859-0569 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck |
| Additional Taxonomies | 207Y00000X Otolaryngology |
| Enumeration Date | 2023-10-24 |
| Last Update Date | 2023-10-24 |