| NPI | 1487407235 |
|---|---|
| Doing Business As | ALIVIA PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | SUSAN PONDER-STANSEL President & CEO 904-407-5050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2024-04-10 |
| Last Update Date | 2024-04-10 |