| NPI | 1588048219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMINE BOURI Surgical Assist 321-946-3584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 159591) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2017-02-15 |