| NPI | 1053866434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA D HANSHEW Business Manager 727-868-9563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NV 8701-ASC-0) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2017-01-17 |