| NPI | 1972718450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONIA ROMAN Billing Clerk 863-419-9301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: FL ME54966) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2013-08-26 |