| NPI | 1306587415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIEGO FERNANDO GOMEZ President 904-531-4556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 207Q00000X Family Medicine | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2022-04-05 |