NPI | 1609392018 |
---|---|
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 |
207RS0010X Internal Medicine, Sports Medicine | |
363A00000X Physician Assistant | |
Enumeration Date | 2017-08-17 |
Last Update Date | 2017-08-17 |