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850 S Palafox St Unit 103 Pensacola FL 32502-5983 | |
(850) 433-6760 | |
(850) 433-1996 |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 850 S Palafox St Unit 103, Pensacola, Florida |
Authorized Official Name and Position | Kevin N Groom (DIRECTOR) |
Authorized Official Contact | 8504336760 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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890 S Palafox St Unit 300 Pensacola FL 32502-5905 Ph: (850) 433-1656 | 850 S Palafox St Unit 103 Pensacola FL 32502-5983 Ph: (850) 433-6760 |
NPI Number | 1194371963 |
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Provider Enumeration Date | 08/16/2019 |
Last Update Date | 01/08/2020 |
Identifier | Type | State | Issuer |
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1194371963 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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