| NPI | 1023557204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER E ROTH Treasurer 407-323-2566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2017-02-21 |