| NPI | 1801299870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE FREY Manager 352-208-1140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: FL PO3604) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: FL PO3605) |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2018-05-18 |