| NPI | 1124216601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN M. VILLALOBOS President 407-331-0771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME44332) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9101382) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2009-04-09 |