| NPI | 1326298803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENEIDA GOMEZ Owner 904-342-0672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME83444) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME 83444) | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2024-04-16 |