| NPI | 1609286897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEEANN MENGEL Administrator 904-376-4275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363A00000X Physician Assistant | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2025-12-18 |