| NPI | 1396517355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT FOWBLE Owner 561-310-4563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2023-10-24 |
| Last Update Date | 2024-03-25 |