| NPI | 1255211850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIRAJ BRAHMBHATT Credentialing Specalist 904-730-1585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-09-04 |
| Last Update Date | 2025-09-24 |