| NPI | 1124064456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENE AB CAPULONG President Surgeon 386-736-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME17644) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2022-07-21 |