Organization
LIVINGLITEMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE L BAUTISTA ARNP-C (OWNER)
(850) 814-9223
Entity
Organization
Contact information
Practice address
2507 HARRISON AVE, SUITE 201, PANAMA CITY, FL 32405-4424
(850) 215-4455
(850) 215-4492
Mailing address
2507 HARRISON AVE, SUITE 201, PANAMA CITY, FL 32405-4424
(850) 215-4455
(850) 215-4492
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
FL
Other
Enumeration date
04/07/2015
Last updated
04/07/2015
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