| NPI | 1245501378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD D GIBSON Owner/ Physhian 850-624-9634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME11148) |
| Enumeration Date | 2012-01-20 |
| Last Update Date | 2012-01-20 |