| NPI | 1942443007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDURADO CHIRINO Predident 305-300-8380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL me72685) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: FL pt7871) |
| Enumeration Date | 2009-04-19 |
| Last Update Date | 2009-05-17 |