| NPI | 1063701977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL VICTOR MINOTTY Manager 772-257-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1345) |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2011-10-03 |