| NPI | 1376029660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC NORENBERG Sole Member 904-273-1180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME56786) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME99489) |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2018-07-19 |