| NPI | 1275789711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN M BODEN President/Physician 850-502-1363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME94719) |
| Enumeration Date | 2008-08-15 |
| Last Update Date | 2008-12-22 |