| NPI | 1215909122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER GREENE Office Manager 904-264-2297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME0032641) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME0053605) |
| 208D00000X General Practice (Licence: FL ME0039226) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2024-03-21 |