| NPI | 1679209183 |
|---|---|
| Other Name | 6525 3RD ST SHIPLEY ROCKWELL |
| Entity Type | Organization |
| Authorized Contact | LORA MORSE VP Professional Fee Services 321-434-6116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2022-07-27 |