| 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 |