| NPI | 1568941276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEEANN MENGEL Administrator 904-202-5305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology |
| 207RP1001X Internal Medicine Pulmonary Disease | |
| 207RX0202X Internal Medicine Medical Oncology | |
| 207VX0201X Obstetrics & Gynecology Gynecologic Oncology | |
| 207X00000X Orthopaedic Surgery | |
| 207Y00000X Otolaryngology | |
| 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery | |
| 2084N0400X Psychiatry & Neurology Neurology | |
| 2085R0001X Radiology Radiation Oncology | |
| 208600000X Surgery | |
| 2086X0206X Surgery Surgical Oncology | |
| 208800000X Urology | |
| 208C00000X Colon & Rectal Surgery | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) | |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2023-04-10 |