| NPI | 1972994770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMMANUEL LAGOUTARIS Owner 904-429-9859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3053) |
| Enumeration Date | 2015-02-15 |
| Last Update Date | 2016-12-23 |