| NPI | 1871014258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANE TRASK CEO 813-787-1128 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2017-07-06 |