| NPI | 1013306414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDA BATAINEH Office Manager 850-785-6272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME0070013) |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2015-01-22 |