| NPI | 1982049995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE G TRACY Owner 850-747-6950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: FL ME45073) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME45073) |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: FL ME45073) | |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2013-05-03 |