| NPI | 1699113605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUE P. LEBEAU Facial Plastic Surgeon/Owner 850-308-1738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: FL Me105524) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2013-06-12 |