| NPI | 1710269097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE C LEE President 813-579-3369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME93895) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2020-01-02 |