| NPI | 1366843625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLETTE BURLESON Practice Manager 352-694-6331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME107880) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME74255) |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2014-09-05 |