| NPI | 1891001939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY A. MOORE President 321-506-6781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9104697) |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2011-12-22 |