| NPI | 1225743404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE GALLO Owner 904-503-5464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2023-01-20 |
| Last Update Date | 2023-09-11 |