| NPI | 1093388217 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | SONYA WARNICK Administrator 321-432-5480 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine | 
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | 
| Enumeration Date | 2021-07-24 | 
| Last Update Date | 2021-07-24 |