| NPI | 1326525437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIDAN ANNE O'CONNOR Owner 407-257-8663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 8838) |
| Enumeration Date | 2018-07-21 |
| Last Update Date | 2018-07-21 |