| NPI | 1629281472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JOESPH SULTENFUSS President 727-734-6710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology Procedural Dermatology (Licence: FL ME34798) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |