| NPI | 1629114426 |
|---|---|
| Doing Business As | WEST FLORIDA PRIMARY CARE - SPANISH TRAIL |
| Entity Type | Organization |
| Authorized Contact | MICKEY PICKLER Vice President 850-523-2117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2007-11-05 |