| NPI | 1033143045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIEN MARK DUC TRAN Sole Officer 850-939-9876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME90850) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2008-09-15 |