| NPI | 1114936044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC STUART BERGER President 904-594-6044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2008-09-18 |