| NPI | 1336577980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA LACERNA-KIMBRELL President 941-954-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME109505) |
| Enumeration Date | 2013-10-17 |
| Last Update Date | 2017-03-08 |