| NPI | 1750892121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD PORTELL Anesthesiologist 772-778-9621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: FL AA425) |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2017-10-12 |