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 |