| NPI | 1639538754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS KOEHLER President 813-393-6247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME104572) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME104572) |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: FL ME104572) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME104572) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME104572) | |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2021-02-22 |