| NPI | 1174518179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANDANA Y BHIDE Md 904-827-0032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME73431) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME73431) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2010-11-10 |