| NPI | 1063940211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA ROSANIA Manager 239-689-8910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3782) |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2022-07-21 |