| NPI | 1518113893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYLE G BREEDING Authorized Official 352-597-3444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME102374) |
| Additional Taxonomies | 2086S0129X (Licence: FL ME102374) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2008-08-19 |