| NPI | 1285177642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICKEY EDSON GORDON Owner 239-566-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO0002638) |
| Enumeration Date | 2016-12-02 |
| Last Update Date | 2016-12-02 |