| NPI | 1295012631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDOLPH AUGUSTUS MALONE Physician 850-656-6269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: GA 0034412) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2022-08-31 |