| NPI | 1205274784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE LYNN AYA-AY Self 813-774-5733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: FL ME103677) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2013-06-17 |