| NPI | 1144270240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA M GIBSON Billing Manager 850-682-7212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Additional Taxonomies | 2086S0129X |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2011-08-25 |