| NPI | 1790859320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L DUPUIS President 850-982-8025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL ME26893) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME26893) |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: FL ME26893) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2010-07-29 |