| NPI | 1285854448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICKEY EDSON GORDON Owner/President 239-566-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL po0002638) |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2015-08-04 |