| NPI | 1043636822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA M CORDERO Medical Doctor 904-388-7968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME57227) |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2014-03-17 |