| NPI | 1679753974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTY W BERTELLI Medical Physician 850-473-8575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME47948) |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2007-11-05 |