| NPI | 1396994166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KINLEY WAYNE HOWARD Owner 850-497-8876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO2112) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP2539562) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP2539562) | |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2011-09-15 |