| NPI | 1780992362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE MOSQUERA Manager 305-279-0159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: FL PA9101874) |
| Enumeration Date | 2010-09-17 |
| Last Update Date | 2010-11-01 |