| NPI | 1972938108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAVIER G LUGO Owner 239-263-4133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL 65726) |
| Enumeration Date | 2013-09-06 |
| Last Update Date | 2013-09-06 |