| NPI | 1417901018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AL E DEEB Executive Director 850-878-5165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 813) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2012-03-21 |