| NPI | 1528456548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN TOBIAS GRAY CEO 954-791-6146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA3649) |
| Enumeration Date | 2014-12-29 |
| Last Update Date | 2026-08-31 |