| NPI | 1407746969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH TIBBS Vice President 904-202-3283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363A00000X Physician Assistant | |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 207R00000X Internal Medicine | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2025-07-07 |
| Last Update Date | 2026-03-03 |