| NPI | 1447857834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANE TRASK CEO 813-787-1128 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine | |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-08 |