| NPI | 1013466382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANE TRASK COO 813-787-1128 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine |
| 207T00000X Neurological Surgery | |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2016-09-28 |