| NPI | 1588142343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMER ANSARI Manager 407-970-3201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine |
| Enumeration Date | 2018-08-03 |
| Last Update Date | 2019-07-22 |