| NPI | 1053635870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN LAMONT SCOTT Owner 813-855-8450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME100433) |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2020-05-07 |