| NPI | 1861768467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY LINDSAY Physician Assistant 850-510-0544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 6388) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-03-28 |