| NPI | 1417545088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER M TRAVIS Chief Operating Officer 813-358-3578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 111NX0800X Chiropractor, Orthopedic |
| 207X00000X Orthopaedic Surgery | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2021-01-08 |