| NPI | 1538258561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANGALA SHETTY Owner 352-622-1840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine |
| 208VP0014X Pain Medicine Interventional Pain Medicine | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2010-02-02 |