| NPI | 1427322882 |
|---|---|
| Former Legal Business Name | SOUTHSIDE OB-GYN, PLLC |
| Entity Type | Organization |
| Authorized Contact | EDY AMISIAL Medical Director/Owner 786-657-2269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME108552) |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2024-06-20 |