| NPI | 1962990325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA C. REYES Owner 239-202-3026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2019-03-18 |