| NPI | 1245983568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER RYAN CEO 904-399-2766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251V00000X Voluntary or Charitable |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-01-27 |
| Last Update Date | 2022-01-27 |