| NPI | 1417265422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT ANTONIO TITUS Owner/Physician 340-715-7779 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: VI 1613) |
| Additional Taxonomies | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2010-09-24 |
| Last Update Date | 2024-06-14 |