| 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 |