| NPI | 1801178975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE L WEST Credentialing 352-237-7646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: FL ME66357) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2011-09-15 |