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 |