| NPI | 1306679279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN MUSA Risk Manager/Administrator 904-210-0862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2024-08-24 |
| Last Update Date | 2025-08-14 |