| NPI | 1124379706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELVIS GRANDIC Director 561-715-3638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: FL ME102652) |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2012-09-24 |