| NPI | 1376569574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA JANE PAUTLER Administrator 813-879-5795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME40175) |
| Additional Taxonomies | 207WX0107X Ophthalmology Retina Specialist |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2024-08-13 |