| NPI | 1366384562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANN SAMPSON Insurance/Credentialing Coordinator 850-206-1133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Enumeration Date | 2026-04-07 |
| Last Update Date | 2026-05-28 |