| NPI | 1962930271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIAMELYS FERNANDEZ Owner 786-449-8559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2025-10-22 |