| NPI | 1285117549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP CARNEVALE Nurse Practitioner 904-609-3349 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 207LA0401X Anesthesiology, Addiction Medicine | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 2083A0300X Preventive Medicine, Addiction Medicine | |
| 261QU0200X Clinic/Center, Urgent Care | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2024-01-09 |