| NPI | 1861883753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFREDA D BLACKSHEAR Owner 850-878-0229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME40463) |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2015-02-12 |