| NPI | 1366463226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY EDWARD OLSSON Medical Director 321-242-9031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL OS0004087) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2015-04-09 |