| NPI | 1124988639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACLYN EVANS Executive Administrator 727-480-2734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 208600000X Surgery |
| 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery | |
| Enumeration Date | 2025-11-17 |
| Last Update Date | 2026-02-17 |