| NPI | 1306140942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AYSHIA ELLIS HATCHER Practice Manager 850-638-4555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS8371) |
| Enumeration Date | 2010-12-22 |
| Last Update Date | 2010-12-22 |