| NPI | 1972161461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN CHAVEZ President 786-803-8550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2022-01-08 |