| NPI | 1679981492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN MORGAN Credentialing COO Rdinator 941-953-7451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX J1900) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: TX J1900) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2014-07-29 |