| NPI | 1982870143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BLANCO Owner 786-243-0149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME57421) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ARNP619302) |
| 207Q00000X Family Medicine (Licence: FL PA9103866) | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2013-03-12 |