| NPI | 1770730459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IAN ANTHONY CONCILIO Owner/Physician 772-873-8501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery |
| 2086S0129X | |
| 2086X0206X Surgery, Surgical Oncology | |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2008-09-30 |