| NPI | 1619214350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SURYA RAO Owner 386-423-0505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME96830) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2013-01-15 |