| NPI | 1104055466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL ITTIG Administrator 727-568-6840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2022-08-30 |