| NPI | 1083430185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHIMENE PEREZ Credentialing Manager 904-750-3344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-11-23 |
| Last Update Date | 2024-12-07 |