| NPI | 1992117600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANTIAGO MOISES Director Of Centers Operations 786-362-4173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2014-05-29 |