| NPI | 1962364919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE CARRILLO RUSSE Nutritionist 787-510-9452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1800X Clinic/Center, Corporate Health |
| Enumeration Date | 2025-11-28 |
| Last Update Date | 2025-11-28 |