| NPI | 1265168090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER D GAMMARANO Owner 904-647-6238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2024-03-22 |