NPI | 1144458621 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL D GILMORE President 850-398-8480 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
Enumeration Date | 2009-06-23 |
Last Update Date | 2009-06-23 |