| NPI | 1578519518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELIA A EVANS President 904-529-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME94840) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME94745) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2012-06-05 |