| NPI | 1568621522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN M O'BRIEN Billing Department 727-341-2408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: FL ME0066063) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2008-06-05 |