| NPI | 1033223367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN J KIRBO Owner President 850-219-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1216) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2014-09-11 |