| NPI | 1548532088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIO G. REVILLA President 954-772-0949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME0021737) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME0021737) |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2012-02-17 |