| NPI | 1306471552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUBRAE RUSSOLELLO Office Manager 727-669-9018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2020-09-28 |