| NPI | 1477946820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DEMETRIOS LAGOUTARIS Owner 813-380-1492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: FL PO3240) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3240) |
| 213ES0131X Podiatrist, Foot Surgery (Licence: FL PO3240) | |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2015-03-10 |