| NPI | 1952909954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YESSICA SAEZ Administrative Assistant 386-279-9777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2020-10-12 |