NPI | 1043290653 |
---|---|
Entity Type | Organization |
Authorized Contact | PAM S. MARRERO Credentialing Specialists 239-215-6884 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Enumeration Date | 2006-01-19 |
Last Update Date | 2024-07-12 |