| NPI | 1912932047 |
|---|---|
| Former Legal Business Name | SPORTS MEDICINE AND JOINT REPLACEMENT SPECIALIST |
| Entity Type | Organization |
| Authorized Contact | MARK FARMER VP 239-482-2663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2022-12-30 |