| NPI | 1235859646 | 
|---|---|
| Doing Business As | SOUTHERN-BREEZE MEDICAL CARE | 
| Entity Type | Organization | 
| Authorized Contact | LISA LEANNE KING Co Owner, Agent 850-527-6489  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family | 
| Additional Taxonomies | 363L00000X Nurse Practitioner | 
| Enumeration Date | 2022-08-29 | 
| Last Update Date | 2022-08-29 |