| NPI | 1811953128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN L MOSS Executive Director 850-431-7021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 261QR1300X Clinic/Center, Rural Health | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2019-01-28 |