| NPI | 1518205038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW L BLACK Manager 239-293-4140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL M80046) |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2013-08-22 |