| NPI | 1417142464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS L BASS Physician 954-966-8559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME66691) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME89620) |
| 208600000X Surgery (Licence: FL OS9744) | |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2012-03-02 |