| NPI | 1770856833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNY GURGEN Owner 352-435-7695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2012-02-20 |
| Last Update Date | 2019-11-18 |