| NPI | 1407801194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY CONNOLLY CFO 850-718-2623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 174400000X Specialist |
| 261QR1300X Clinic/Center, Rural Health | |
| 282NR1301X General Acute Care Hospital, Rural (Licence: FL 3999) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2023-01-23 |