| NPI | 1760875983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN PORTER Chairman Of The Board 850-469-2338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 412) |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2015-03-12 |