| NPI | 1043398621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE YOUNGBLOOD Billing 850-769-7270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME67903) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |