| NPI | 1982643169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICKEY PICKLER VP 850-523-2117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2008-10-15 |