| NPI | 1619262813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD DEFREITAS Member Manager 941-798-3524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2013-05-16 |