| NPI | 1396104915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON R BURGESS Owner 727-433-1461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9108894) |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2016-12-19 |