| NPI | 1235533829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FADY EL BAHRI Owner 904-328-5979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: FL ME49020) |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2021-09-29 |