| NPI | 1619492642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONARD PAUL JOHNS President 813-310-5679 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: FL PA9102691) |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2022-07-21 |