| NPI | 1548586894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEWIS JOHN OBI Medical Director 904-399-0905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME 12407) |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2010-04-12 |