| NPI | 1982991907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRISELL HERNANDEZ President 305-649-6090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL 5705782) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2011-06-29 |