| NPI | 1245471069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MARTINEZ Billing 813-496-1075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME48678) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME48678) |
| Enumeration Date | 2009-03-09 |
| Last Update Date | 2010-12-14 |