| NPI | 1982855359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAISY MARTINEZ Owner/President 239-772-1194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2008-10-03 |
| Last Update Date | 2024-07-29 |