| NPI | 1275323255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT TRENT CARTER Owner 904-399-6165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2025-05-12 |