| NPI | 1962109611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOEL TEJEDA Owner 954-417-4499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2024-12-03 |