| NPI | 1588042568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT PENDLETON Manager 772-249-9450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL AP1293) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL Ap1293) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2015-10-19 |