| NPI | 1942585062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORGE F LOPEZ President 305-221-9161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: FL MM26296) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2011-10-20 |