| NPI | 1952323081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL TELLIN Practice Adminstrator 239-566-5748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QS0132X Clinic/Center, Ophthalmologic Surgery (Licence: FL 1232) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2025-03-26 |