| NPI | 1871605329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RITA L GRIFFITH CEO 321-728-1599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL 2019732) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |