| NPI | 1346212669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICE TALLEY BIDWELL Owner/President 850-656-4277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2022-07-21 |