| NPI | 1669666764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA RYAN DAVENPORT Office Manager 850-656-1997 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME25681) |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2012-01-25 |