| NPI | 1184215006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMAR JISHI MOORE Md/Owner 850-855-8764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 2084N0400X Psychiatry & Neurology Neurology | |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology | |
| Enumeration Date | 2021-02-02 |
| Last Update Date | 2025-03-12 |