| NPI | 1891123378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD RAY SMITH Owner 850-393-1181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9105176) |
| Enumeration Date | 2013-10-21 |
| Last Update Date | 2013-10-21 |