| NPI | 1154615326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN ECKERT President 863-521-7105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: FL ME72650) |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 208600000X Surgery | |
| 2086S0102X Surgery, Surgical Critical Care | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2016-09-09 |