| NPI | 1609948330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD JOHN GROSS Physician 407-333-3040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME0074351) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |