| NPI | 1891165023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN B WALLS Physician / Owner 321-243-8593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME71812) |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2017-05-22 |