| NPI | 1912881871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE SELLEY MARTINCAK Owner, Practitioner 850-387-5111 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2025-08-04 |
| Last Update Date | 2025-08-04 |