| NPI | 1740201607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE L MADANI Business Office Manager 850-205-8404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 749) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2008-06-05 |