| NPI | 1104293380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE COSAMANO Mngr 727-348-4472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9105825) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-08-24 |