| NPI | 1972901064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANIA VELEZ Manager 321-356-6864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME111142) |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2014-12-05 |