| NPI | 1396283628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA COCHRAN Credentialing Coordinator 904-737-2722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME128260) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2020-12-23 |