| NPI | 1487765566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA DAWN HANSHEW Business Manager 727-868-9563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine |
| 207T00000X Neurological Surgery | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-01-26 |