| NPI | 1134315237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN M COLORADO Owner 813-849-1258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology Procedural Dermatology (Licence: FL ME87583) |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2007-09-21 |