| NPI | 1982597050 |
|---|---|
| Other Name | 923 WEST 29 ST |
| Entity Type | Organization |
| Authorized Contact | SANDRA M DEL ROSARIO Principal 786-616-8932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Enumeration Date | 2025-05-29 |
| Last Update Date | 2025-05-29 |