| NPI | 1376787614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KURT ERICKSON President 727-446-5681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2009-04-30 |