| NPI | 1558730085 |
|---|---|
| Doing Business As | MEDI WEIGHTLOSS |
| Entity Type | Organization |
| Authorized Contact | BLAKE A KOZOL President 904-625-0038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: FL ME42368) |
| Additional Taxonomies | 207RB0002X Internal Medicine, Bariatric Medicine |
| 207VB0002X Obstetrics & Gynecology, Bariatric Medicine | |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2015-09-15 |