| NPI | 1265749428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES CARLTON WHITED President 904-384-9007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9279002) |
| Additional Taxonomies | 163WR0400X Registered Nurse, Rehabilitation (Licence: FL 9279002) |
| 174H00000X Health Educator (Licence: FL 9279002) | |
| 261QM1300X Clinic/Center, Multi-Specialty (Licence: FL 9279002) | |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2013-06-19 |