| NPI | 1457523003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN C VIVERO President 904-460-0707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME76599) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME76599) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2011-09-15 |