| NPI | 1528366846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE F ROYCE Owner 941-358-3223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: FL 058381) |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2021-09-10 |