| NPI | 1932780590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENIO REYES MIRANDA Owner 786-321-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251B00000X Case Management |
| 208D00000X General Practice | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2023-05-18 |