| NPI | 1174078281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VITALY BLATNOY Owner 407-706-1770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck | |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2024-07-12 |