| NPI | 1053286823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEEPA GRANDON Owner/Medical Director 850-296-5091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2025-10-09 |
| Last Update Date | 2025-10-09 |