| NPI | 1689196248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUSTAVO DE JESUS-GOMEZ Owner/President 863-937-3139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME112008) |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2024-03-25 |