| NPI | 1275667057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI JAZAREVIC Office Manager 772-233-6166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME 65570) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: FL me65570) |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL me65570) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: FL me65570) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2021-05-21 |