| NPI | 1962674234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAPHAEL LUIS LOPEZ Owner/President 863-421-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL me85048) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2008-10-20 |