| NPI | 1174596167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN J BOMALASKI Owner 321-434-4656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2020-08-22 |