| NPI | 1659572816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYON SCOTT RAYNES President 850-469-2319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2022-07-21 |