| NPI | 1366589780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTA JACENYIK President 850-934-9866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: FL ME67496) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2014-03-03 |