| NPI | 1174713531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK P KOTLARZ Physician 850-471-2377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2021-05-18 |