| NPI | 1366462103 |
|---|---|
| Former Legal Business Name | JACKSONVILLE BEACH PEDIATRIC CARE CENTER, INC |
| Entity Type | Organization |
| Authorized Contact | NORBERTO BENITEZ Medical Director 904-249-3373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2014-04-10 |