| NPI | 1275668063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW J PETRELLA Owner 352-746-2663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME0074278) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME0080012) |
| 213E00000X Podiatrist (Licence: FL PO0002716) | |
| 225100000X Physical Therapist (Licence: FL PT20489) | |
| 225100000X Physical Therapist (Licence: FL PT8397) | |
| 225X00000X Occupational Therapist (Licence: FL OT3425) | |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA3291) | |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9101478) | |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA3291) | |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9101478) | |
| 363A00000X Physician Assistant (Licence: FL PA9108675) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2015-04-27 |