| NPI | 1972904027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCNER NELSON Senior Member 305-318-1252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL Me107333) |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2014-09-09 |