| NPI | 1548271794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE Y RAY Medical Director President 813-760-5104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: ID M8087) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: LA MD022804) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME86922) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2025-09-11 |