| NPI | 1245751692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ANDREW MATEY President 904-268-3686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO2521) |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2018-03-17 |