| NPI | 1205839487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBEN BERROCAL TIMMONS Medical Director/Administrator 850-484-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1061) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2020-08-22 |