| NPI | 1437347416 |
|---|---|
| Former Legal Business Name | PRIOR NAME: JOURNEY LITE OF NORTH FLORIDA, LLC |
| Entity Type | Organization |
| Authorized Contact | ROBERT CYWES Governing Body Chair 904-399-4004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2010-06-21 |