| NPI | 1164900338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA JAHEN SMITH Physician Assistant 813-368-0683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9105946) |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2018-07-31 |