| NPI | 1700217460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA OQUENDO Credentialing Specialist 941-315-9955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME70208) |
| Enumeration Date | 2013-12-06 |
| Last Update Date | 2023-03-06 |