| NPI | 1780703561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW STEWART ELLIS President 352-333-5911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: FL ME96520) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-05 |