| NPI | 1598995599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON KIMBALL Director 904-202-6293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2021-03-03 |