| NPI | 1023088473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MADEWELL Administrator 850-769-3191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1178) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2022-07-29 |