| NPI | 1902890239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH EUGENE MASSULLO President 352-746-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| 207ND0900X Dermatology, Dermatopathology | |
| 207NS0135X Dermatology, Procedural Dermatology | |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2011-11-15 |