| NPI | 1154577021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN BARRY ROACH President 727-378-5808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL OS9566) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL OS9566) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2011-04-19 |