| NPI | 1083661383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIVANTA J PAUL President 904-279-1666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME56495) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2020-03-09 |