| NPI | 1588601421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICARI SUSAN ERWIN-WILSON Bussiness Owner/Md 850-219-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 800017593) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2008-09-30 |