| NPI | 1245525518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS DODARO President 904-854-7911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL P10000084848) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2011-06-23 |