| NPI | 1700307550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNA HOWARD-GONZALEZ Owner 850-374-7604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: FL ND3885) |
| Enumeration Date | 2017-07-02 |
| Last Update Date | 2022-09-13 |