| NPI | 1821115841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE L. ETTEL Physician 727-824-8357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 790) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2008-05-05 |