| NPI | 1598280828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYON SCOTT RAYNES President 850-469-2319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2017-08-08 |