| NPI | 1629766969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CURTIS LEE BEAUREGARD Owner 239-236-8933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2023-04-25 |
| Last Update Date | 2023-04-25 |