| NPI | 1972261253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULINE HENRY Mm 786-439-6990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2021-12-03 |
| Last Update Date | 2021-12-03 |