| NPI | 1265216170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN MARIE BRANCIFORTE Operations Admin 904-334-0910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207RB0002X Internal Medicine Obesity Medicine |
| 2084N0400X Psychiatry & Neurology Neurology | |
| 2086S0129X Surgery Vascular Surgery | |
| 208C00000X Colon & Rectal Surgery | |
| Enumeration Date | 2023-08-22 |
| Last Update Date | 2025-01-30 |