Graduated: 2020
NPI: 1285883918
Practice Locations (2)
FLORIDA DEPARTMENT OF HEALTH
139 12TH ST
APALACHICOLA, FL 323202110
8506532111
FLORIDA DEPARTMENT OF HEALTH
2475 GARRISON AVE
PORT SAINT JOE, FL 324565265
8502271276
Source: CMS National Downloadable File, September 2026.