| NPI | 1962079814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDDY MARINO LEYVA President 786-409-3454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2024-08-29 |