| NPI | 1588633481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK R GROOVER CEO 904-398-3262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: FL 1092) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2010-01-12 |