| NPI | 1548690258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP STAATS Director 904-281-1066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 261QS1200X Clinic/Center, Sleep Disorder Diagnostic |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2014-10-02 |