| NPI | 1801152392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HALEY DICKEY Biller 321-693-1936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9188098) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2012-04-09 |