| NPI | 1316483860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCIANO JOHN RADI Owner/A.O./P.A. 954-594-1527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL pa9104117) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2018-04-05 |