| NPI | 1467085902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM KUETTEL CEO 850-262-8645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 261Q00000X Clinic/Center | |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 332900000X Non-Pharmacy Dispensing Site | |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2020-10-07 |