| NPI | 1689019416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY W CHIZMAR President 850-640-0014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL PN1160941) |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2013-05-07 |