| NPI | 1972790764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KETAN A PATEL Owner 850-215-8035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2013-03-07 |