| NPI | 1154601706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES D DUVA President 386-274-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care (Licence: FL 10699) |
| Enumeration Date | 2011-08-26 |
| Last Update Date | 2011-08-26 |