| NPI | 1710250048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES R THOMPSON Pst 850-476-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: FL ME 53590) |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2012-02-16 |