| NPI | 1639151160 |
|---|---|
| Former Legal Business Name | BERRYHILL MEDICAL PLAZA LLC |
| Entity Type | Organization |
| Authorized Contact | LISBETH VERNALI Owner 850-476-9691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME65994) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2018-09-20 |