| NPI | 1972997682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAUDEL LA O President 786-334-6170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2015-04-20 |