| NPI | 1902839798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAURI GLENN LUNDERMAN Owner/Physician 850-864-3232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME64728) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2010-02-03 |