| NPI | 1629947346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA BALLANTINE Head Of Clinical Operations 850-645-9451 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 170300000X Genetic Counselor, MS | |
| 207R00000X Internal Medicine | |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2025-10-31 |
| Last Update Date | 2026-03-10 |