| NPI | 1164830725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD G BRUNNER President 850-209-4576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: FL ME0046858) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2014-08-12 |