NPI | 1083729248 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL W PERRY Medical Director 813-289-9613 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1250) |
Enumeration Date | 2006-08-20 |
Last Update Date | 2017-01-25 |