NPI | 1710515895 |
---|---|
Entity Type | Organization |
Authorized Contact | VINCENT DEPASQUALE Owner/ Provider 352-398-1231 |
Organization Subpart ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
Additional Taxonomies | 111N00000X Chiropractor |
208D00000X General Practice | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2020-04-01 |
Last Update Date | 2021-09-03 |