| NPI | 1184662785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON BUTLER Practice Administrator 904-482-4050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME64364) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2020-08-22 |