| NPI | 1417948159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY REED Administrative Credentialing 850-201-4861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2009-11-12 |