| NPI | 1306132527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN C BROCK Managing Member 813-839-6299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME41814) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2011-06-27 |