| NPI | 1922697150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS MAZA President 786-953-6263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2022-08-23 |