| NPI | 1942054614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONIA IVELISSE BONILLA President 787-599-5010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2024-04-17 |