| NPI | 1043774003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD G MACKAY Partner 727-781-5652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery |
| Additional Taxonomies | 202K00000X |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2019-01-24 |