| NPI | 1952055964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRISAIDA DUARTE Administrator 786-315-6818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 261Q00000X Clinic/Center | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2022-02-08 |