| NPI | 1063032993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE VOLLMER CFO 863-577-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| 2086S0129X Surgery, Vascular Surgery | |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2020-04-21 |