| NPI | 1174945521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE PHILLIP GREYSLAK Managing Member 407-451-0192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9104508) |
| Enumeration Date | 2014-01-19 |
| Last Update Date | 2023-12-13 |