| NPI | 1124412705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHMOUD ISMAIL ALI Owner 850-408-0839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME110173) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2015-03-23 |