| NPI | 1548103864 |
|---|---|
| Doing Business As | PONTE VEDRA PREMIER HEALTHCARE |
| Entity Type | Organization |
| Authorized Contact | LEONIE CICELY KING CEO 757-842-0062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2026-04-11 |
| Last Update Date | 2026-04-11 |