| NPI | 1659637825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN MAYNARD Office Mgr 850-270-2710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME79385) |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2018-03-26 |