| NPI | 1689010837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE R MONAST Manager 727-586-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: FL PO1709) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2016-03-01 |