| NPI | 1073839718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADETRIC NAFAYE WOOD Geriatric Nurse Practitioner 850-322-1895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology |
| 207QA0505X Family Medicine, Adult Medicine | |
| 261Q00000X Clinic/Center | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2022-12-02 |