| NPI | 1124411525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CECILIA C. OLAZAR Director 904-285-1113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL 51858) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2015-03-09 |