| NPI | 1033194816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY CLARK Practice Manager 727-767-3221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: FL ME0055290) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2020-08-22 |