| NPI | 1528772480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN JOHNSON Owner 850-215-7095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2023-10-03 |