| NPI | 1982892501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL B. RIGDON Physician 321-536-3634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL me75248) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2007-10-09 |