| NPI | 1043358005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS H. GAMA Group Practice Owner 904-733-4262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME0039492) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2009-08-11 |