| NPI | 1265675219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FURRIN KUDIA Office Manager 904-461-9330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME0068850) |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2010-07-12 |