| NPI | 1710389234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS EUGENE BOLER Owner 813-600-0252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME91494) |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2015-10-27 |