| NPI | 1578777504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYED S HUSSAIN CEO 904-771-1116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: FL ME74307) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2022-07-29 |