| NPI | 1992982722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAUL B ZELAYA Presdient 386-752-6506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ME34230) |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2008-01-23 |