| NPI | 1639172505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGIE FAYE AUSTIN Administrative Assistant 904-358-8441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology (Licence: FL HCC5686) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2012-12-05 |