| NPI | 1679525653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | UTPALKUMAR PATEL Owner 352-796-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME73174) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL ME79778) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2021-04-22 |