| NPI | 1518140425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSH MAYWALT Billing Manager 407-352-1030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2007-12-13 |