| NPI | 1942641675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONA MCCULLOUGH President 727-645-4541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2088F0040X Urology Female Pelvic Medicine and Reconstructive Surgery (Licence: FL ME107055) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2013-07-10 |