| NPI | 1598483414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW WEAVER Practice Administrator 904-395-7772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2024-11-05 |