| NPI | 1164827010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS FERNANCO TOBON Medical Director 407-492-5931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME98764) |
| Additional Taxonomies | 2471S1302X Radiologic Technologist Sonography (Licence: FL 120313) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2016-02-05 |