| NPI | 1184305435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES TARVER Director 904-403-2079 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 261QC1500X Clinic/Center, Community Health | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2023-07-28 |
| Last Update Date | 2023-07-28 |