| NPI | 1043346745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDOLPH EDENS THORNTON Senior Physician 904-389-4140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2022-07-21 |