| NPI | 1649509878 |
|---|---|
| Doing Business As | VANTAGE UROLOGIC INSTITUTE |
| Entity Type | Organization |
| Authorized Contact | DONALD RUSSELL LOCKE Managing Member 352-861-2115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Enumeration Date | 2009-12-17 |
| Last Update Date | 2018-05-08 |