| NPI | 1205240363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAQUEL SKIDMORE Medical Director 850-640-1530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ACN244) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2014-06-17 |