| NPI | 1134364235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY THOMAS Practice Manager 727-895-1515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME0076386) |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2009-02-05 |