| NPI | 1093052656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM JAMES SHANAHAN Physician 850-484-8448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME0032249) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2013-01-15 |