| NPI | 1518012913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM J NAMEN Owner 904-636-9197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: FL PO2208) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2008-11-11 |