| NPI | 1710321781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROCK LOVELACE Manager 813-220-5535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: FL ME31942) |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2013-04-22 |