NPI | 1033601794 |
---|---|
Doing Business As | HWY 90 PEDIATRICS |
Entity Type | Organization |
Authorized Contact | CHANDRA SMILEY Executive Director 850-436-4630 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2018-05-30 |
Last Update Date | 2018-11-30 |