KEEFE & BURTON MD PA
Medical Practice at College Blvd, Niceville, FL

License number
Florida ME0056714
Category
Medical Practice
Type
Pediatrics
License number
Florida ME0060775
Category
Medical Practice
Type
Pediatrics
Owner
Name: LYNN M KEEFE ME10056714
Title: MD
Phone: (850) 678-9009
Address
Address
1001 College Blvd W SUITE C, Niceville, FL 32578
National Provider ID: 1982696589
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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KEEFE & BURTON, M.D., PA

Niceville, FL

Status:
Inactive
Inactive reason:
AMENDMENT AND NAME CHANGE
Registration:
May 20, 1991
Inactive since:
Jul 26, 1996
Addresses:
1001 - W College Blvd SUITE C, Niceville, FL 32578 (Physical)
1001 College Blvd W, Niceville, FL 32578
State ID:
S54058
Business type:
Florida Profit Corporation
Secretary, Chairmans:
Lynn M Keefe (Secretary, President), 1001 W College Blvd SUITE C, Niceville, FL 32578 (Physical),Tracey R Burton-Lindner, 1001 W College Blvd SUITE C, Niceville, FL 32578 (Physical),Tracey R. Burton-Lindner (Secretary, Chairman)
Agent:
Lynn Keefe,1001 W College Blvd SUITE C, Niceville, FL 32578 (Physical)
EIN:
59-3079318

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