| NPI | 1275518284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERMAN R MATALLANA President 863-701-9510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: FL OS7773) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2008-10-14 |