| NPI | 1174635148 |
|---|---|
| Former Legal Business Name | PLASTIC AND COSMETIC SURGERY CENTER |
| Entity Type | Organization |
| Authorized Contact | A.H. NEZAMI President 904-399-5061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |