| NPI | 1235423989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALINA MARIA GALLIANO-PARDO Owner 904-853-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| Enumeration Date | 2011-05-30 |
| Last Update Date | 2022-07-08 |