| NPI | 1104490416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THABATA FORD Vice President 904-391-5578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology |
| Additional Taxonomies | 207RA0002X Internal Medicine, Adult Congenital Heart Disease |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2021-05-20 |