| NPI | 1366539090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARSHA L PERRY Practice Administrator 904-260-9502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME61123) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2020-08-22 |