| NPI | 1649083999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN M BRANCIFORTE Owner 904-334-0910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology |
| 207V00000X Obstetrics & Gynecology | |
| 2085R0204X Radiology Vascular & Interventional Radiology | |
| 2086S0129X Surgery Vascular Surgery | |
| Enumeration Date | 2025-01-30 |
| Last Update Date | 2025-01-30 |