| NPI | 1568512663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN MILLER Owner 904-398-9861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME53959) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2020-08-22 |