| NPI | 1790285229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MCNAMARA CFO 239-597-2010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2019-08-08 |