| NPI | 1194810762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM MICHAEL HANEY Physician 850-678-6601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME0055821) |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2010-09-16 |