| NPI | 1174705644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIDYA DORAISWAMY Credentialing Specialist 954-680-2108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL me71406) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2020-02-24 |