| NPI | 1902844038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA L HENRY Office Manager 407-898-1436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2019-12-04 |