| NPI | 1972796514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILSON LOPEZ President 305-591-2988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine |
| 207QA0505X Family Medicine, Adult Medicine | |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2021-06-30 |