| NPI | 1962190116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA MONTES Provider Enrollment Specialist 305-595-0109 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2024-04-11 |