| NPI | 1114356680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WYATT IRVIN HENDRICKS COO 850-251-5688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME28955) |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2013-11-07 |