| NPI | 1801066527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE BALIS Office Manager 813-977-3776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME0041511) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME0028912) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2012-01-10 |