NPI | 1063457273 |
---|---|
Entity Type | Organization |
Authorized Contact | AMBER NICHOLE DOCKENEY Credentialing Supervisor 352-372-9414 |
Organization Subpart ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology |
Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
208200000X Plastic Surgery | |
Enumeration Date | 2006-06-19 |
Last Update Date | 2023-01-12 |