NPI | 1811598105 |
---|---|
Entity Type | Organization |
Authorized Contact | KYLE S CHAVERS Owner 850-269-9000 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
Enumeration Date | 2020-11-04 |
Last Update Date | 2020-11-04 |