| NPI | 1497880819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISHMEAL MAJOR Owner 904-254-9643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME94659) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2020-08-22 |