| NPI | 1497891501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK NAGRANI Medical Director 386-423-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1017) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |