| NPI | 1104137348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL RENARD WHITMORE Vice President 941-351-6131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME20929) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2010-08-11 |