| NPI | 1891961462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD RUSSELL LOCKE Managing Member 352-861-2296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: FL 800025941) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2018-05-08 |